Dr. John Paul Bonvillian, DPM
Podiatrist, Foot & Ankle Surgery in Winston Salem, NC. Individual provider (NPI-1).
NPI number1336677046
StatusActive
Last updated in NPPESAug 2, 2021
Details
- NPI
- 1336677046
- Entity type
- Individual (NPI-1)
- Name
- Dr. John Paul Bonvillian
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 24, 2017
- Certification date
- Aug 2, 2021
- Last updated
- Aug 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 707 | NC | Yes |
| 213E00000X | Podiatrist | 07001329A | IN | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
Medical Center BlvdWinston Salem, NC 27157-0001
Phone 336-716-2255 · Fax 336-716-3202
Mailing address
Medical Center BlvdWinston Salem, NC 27157-0001
Phone 336-716-2255 · Fax 336-716-3202
Other practice locations
1 Medical Center Blvd Department Of Orthopaedic Surgery
Winston Salem, NC 27157
Winston Salem, NC 27157
Phone 336-716-3448
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